A common type of biceps tendon tear is detachment (partial or complete) of one of the biceps tendons within the shoulder joint. There are two attachments of the biceps tendon at the shoulder, one within the shoulder joint (the long head of the biceps) and the other in front of the shoulder joint (the short head of the biceps). Injuries to the proximal biceps tendon almost always involve the long head of the biceps. When the long head of the biceps tendon is damaged, a treatment that may be considered is biceps tenodesis.
A biceps tenodesis procedure involves cutting the long head of the biceps just prior to its insertion on the superior labrum and then anchoring the tendon along its anatomical course more distally along the humerus. A number of different anchoring techniques are currently used by surgeons. These techniques include fixation devices such as cortical buttons, Bio-Tenodesis screws and suture anchors. The key to performing a biceps tenodesis is moving the tendon from its normal attachment within the shoulder joint to a new location further down the humerus. An optimal technique would be characterized by limited anterior incisions, early range of motion due to strength and gapping of the repair, and minimum complications.
There is a need for improved methods of attachment of the biceps tendon outside of the shoulder joint that can cause fewer problems within the joint. Also needed are methods and devices that allow internalization of the biceps tendon with use of fixation devices (such as cortical buttons) that are tensioned outside a smaller converged drill hole.